Combating Social Isolation Through an Integrative Approach

April 4, 2022

Article was written by WholeHealth Living

“Withdrawing from the world around me started when I noticed that I couldn’t keep up with those around me,” author and comedian Greg Mania wrote for HuffPost. “I started turning down invitations for anything outside of my comfort zone and instead kept my social activity relegated to things I could easily cut short in case any of my symptoms started to flare up… My world shrunk to the dimensions of my apartment and resulted in the kind of loneliness that the chronically ill know too well.”1

People living with chronic pain and other conditions know Greg’s experience with loneliness too well. The difference is that Greg Mania suffers chronic pain at 32 years old. As we emerge from the COVID pandemic, we have a small taste of the social isolation that chronic sufferers face daily.

“The pandemic has had such an immense impact on our society, to the point where we still haven’t fully grasped the consequences yet,” said Paraskevi Noulas, PsyD, a psychologist at NYU Langone Health. “Humans are social creatures who crave interaction with others. Without it, our mental health can significantly deteriorate.”2

Social Isolation is a Growing Health Concern

Unlike the subjective feelings of loneliness, social isolation is a clinical measure based on the size of one’s social network, frequency of contact, participation in social activities, and other social barriers and measures. Isolation has long been recognized as the plight of growing old, but only recently has the societal cost of social isolation been measured more carefully.

Several studies have documented how loneliness affects us physically. In a study of loneliness across 113 countries, researchers found:

“Loneliness increases the risk of high blood pressure, heart disease, and stroke.
Older adults who feel socially isolated are also at an increased risk of dementia.”3

A study out of Germany charted how social isolation raises cardiovascular risks similar to smoking:

“Chronic social isolation has been shown to increase the risks of morbidity and mortality
similar to known factors, including high blood pressure, smoking, and obesity.”4

Humans thrive on meaningful social connections and researchers are finally beginning to understand how loneliness and social isolation are linked to adverse health outcomes. The study above found links to:

  • Increased activation of the hypothalamic-pituitary-adrenal axis
  • High blood pressure
  • Increased cholesterol levels
  • Coronary heart disease
  • Sleep disturbance
  • Increased risk of mild cognitive impairment and dementia
  • Behavioral health leading to substance misuse, and suicidal ideation

Working with Health Plans

Tivity Health® has worked to mitigate the health impact of social isolation through SilverSneakers®, the nation’s leading fitness program designed specifically for seniors and decades of experience partnering with health plans. Tivity Health has found the risk of social isolation increasing as people age due to multiple factors, including retirement, living alone or in a rural area, but most importantly, the loss of independent mobility from chronic conditions.

Consider the Numbers: Health Impact of Social Isolation

  • 1 out of 3  older adults live alone.5
  • Loneliness and social isolation affect as many as 43% of older adults.6
  • Social isolation increases risk of mortality by 62% to 75% –more than obesity, high cholesterol, or high blood pressure.7
  • Social isolation is equivalent to the health risks of smoking 15 cigarettes per day and reducing a lifespan by 8 years.8

Not surprisingly, these health impacts carry a financial cost:

Consider the Numbers: Financial Impact of Social Isolation9

  • Social isolation is the 4th leading chronic disease behind diabetes, heart disease and high blood pressure.
  • Total cost of social Isolation is $6.7 billion per year to Medicare.
  • Health care costs of socially isolated seniors are estimated to be on average $134 more per month than seniors living in a community.

The Social Impact of SilverSneakers

For the last 30 years, the SilverSneakers fitness program has successfully kept health plan members socially connected compared to non-enrollees. In a study published in the Journal of Applied Gerontology, active participation in a fitness program had a measurable impact on health and loneliness:10

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The Health Impact of WholeHealth Living

For all the proven benefits of exercise, health plan members typically won’t access a fitness program amid chronic pain. Tivity Health offers WholeHealth Living® as a companion program to SilverSneakers to create a total package – a non-pharmacological, non-invasive approach to health enhancement, pain management, and social connection.

WholeHealth Living is helping health plans bring nonpharmacologic and alternative therapies to their members through its managed network of Physical Medicine and Integrative Health solutions. WholeHealth Living identifies, builds, contracts, credentials, and manages a national network of licensed practitioners. The network includes chiropractors, acupuncturists, massage therapists, physical therapists, and naturopathic practitioners.

By connecting mainstream medicine with WholeHealth Living’s network of integrative health practitioners, health plan members can reduce their reliance on opioids and return to a life they love. Payers can address their members’ pain while reducing the cost of expensive treatments.

Evidence-based Results

Mainstream healthcare has begun to embrace integrative pain treatments with the number of new studies and evidence. A 2018 study enrolled 750 active-duty military personnel with back pain. Half received standard care (medications, self-care, and physical therapy), while the other half received standard care plus up to 12 chiropractic treatments.

After six weeks of treatment, those receiving chiropractic care reported:

  • Reduced pain
  • Less disability and more improvement in function
  • Higher satisfaction with their treatment
  • Less need for pain medicine

The study found “the strongest evidence to date that chiropractic care is safe, effective, and results in high levels of patient satisfaction and perceived treatment benefit, thus strengthening our knowledge regarding this conservative non-drug option for low back pain.”11

The Downstream Impact of Isolation – Turning it Around

To restore health, regain function, and join a fitness program socially isolated members must overcome a costly series of barriers:

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Non-medical factors contribute to social isolation, including societal barriers, geography, and transportation needs. Children also start new lives, friends move away, and retirement leaves a void.

Because social isolation results from multiple factors, interventions must be tailored to the needs of the individual. Tivity Health is working to address multiple risk factors ranging from health care utilization, chronic conditions, community access, and other social determinants of health.

“We are working to deeply understand each population’s needs and develop new strategies to identify and invite isolated individuals back into a health-enhancing sense of community,” said Cindy Frost, Senior Director of Product Management at WholeHealth Living. “We are also leveraging new technologies and partnerships that identify isolated seniors and encourage them to participate in connected social settings. The synergy between SilverSneakers and WholeHealth Living shows particular promise in bringing health plan members into a culture of health improvement, activity, and social engagement.”

Tivity Health, through the work of SilverSneakers and WholeHealth Living, is creating a new paradigm for health. This approach connects plan members to a broad network of physical medicine and integrative practitioners, gyms, fitness centers, community classes, and partner organizations that address the social determinants of health among the elderly.

To learn how WholeHealth Living alleviates social isolation with the support of Physical Medicine and Integrative Health solutions, visit www.wholehealthliving.com.

[1] https://www.huffpost.com/entry/chronic-illness-fibromyalgia-young_n_621fcb46e4b0783a8f0a2ae5

[2] https://www.healthline.com/health-news/loneliness-can-affect-you-mentally-and-physically-heres-how-to-cope

[3] https://www.bmj.com/content/376/bmj-2021-067068

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831910/

[5] “The Epidemic of Loneliness,” The Wall Street Journal, 4/19/18, https://blogs.wsj.com/experts/2018/04/18/the-epidemic-of-loneliness-and-how-to-combat-it/

[6] Perissinotto CM, Cenzer IS, Covinsky KE. Loneliness in Older Persons: A predictor of functional decline and death. Archives of internal medicine. 2012;172(14):1078-1083.

[7] Valtorta et al. Loneliness and social isolation as risk factors for coronary heart disease and stroke. Heart. 2016;102(13):1009-16.

[8] https://www.multivu.com/players/English/8294451-cigna-us-loneliness-survey/docs/IndexReport_1524069371598-173525450.pdf 

[9] https://www.aarp.org/content/dam/aarp/ppi/2017/10/medicare-spends-more-on-socially-isolated-older-adults.pdf

[10] https://journals.sagepub.com/doi/full/10.1177/0733464818807820 [1] https://www.spineuniverse.com/treatments/chiropractic/chiropractic-eases-low-back-pain-military-members

[11] https://www.spineuniverse.com/treatments/chiropractic/chiropractic-eases-low-back-pain-military-members